Let’s start a discussion about serving CWS in the schools!

Hi All!

A recent episode of StutterTalk (Ep. 629) got me thinking about the challenges related to providing quality stuttering therapy in the schools. Prior to listening to this, I have heard that school-based stuttering therapy can be less than effectual. I assume this is for the normal reasons- stuttering is low incidence, SLPs lack experience, SLPs maybe don’t know how to approach emotions and reactions to stuttering… But, I was wondering if anyone knows, or can brainstorm specifically, why this setting poses extra challenges for SLPs? I know that a lot of CWS are not afforded the ability to see a private practitioner, and these school-based clinicians are what the kids have. I feel we need to improve treatment in the schools, but this starts with identifying the issues these clinicians face in this setting. Then we are better equipped to help them navigate around, or work with these challenges. I plan to survey school-based clinicians, but was wondering what some of y’all thought or know from experience! Thanks for your time!

Alison LaJuett, B.A.
Graduate Student Clinician
Speech-Language Pathology
University of Akron
ael58@zips.uakron.edu

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Comments

Let’s start a discussion about serving CWS in the schools! — 4 Comments

  1. Great questions. And you are on track in your thinking… we must identify the roadblocks that are interfering with quality therapy before we can make improvements. Research shows that many SLPs are indeed uncomfortable with treating stuttering for many of the reasons you mentioned… low incidence, limited experience, don’t know how to address emotions. Also, stuttering has fewer continuing education opportunities than other disorders. And not every graduate program has a full course on stuttering. For these reasons, it is no wonder that SLPs struggle in treating stuttering.

    Other factors that impact effectiveness of therapy in the school settings may include limited planning time, shorter sessions, and decreased parent involvement. Given your environment, consider if having longer sessions would be helpful. Would you be able to more thoroughly explore attitudes and emotions about speech if you had 45 minutes instead of 30? Would group make it better or worse for that child? Can you plan and prepare a stockpile of well-thought out materials at the start of the semester/year so that you don’t have to scramble at the last minute? Perhaps create a kit or booklet? then make appropriate modifications to individualize or adapt materials. How can you get parents regularly involved? Having the luxury of a university clinic where parents sit on the other side of the glass watching everything that goes on leaves them feeling more connected to therapy sessions with a greater understanding of the process. Schools don’t have those awesome 2 way mirrors or regular parent involvement. Can you invite parents to a few sessions? Call them on the phone? Send notes home? Video a session or a series of sessions? (In my opinion, watching therapy has a far greater impact than reading or hearing about it.) Connecting with families frequently is key.

    Also, do you (as a new SLP or someone who does not have a lot of experience with stuttering) have a support person or a local expert that you can connect with? Don’t be shy about asking questions. Anybody who is knowledgable about the field of stuttering knows that treatment of the disorder can be intimidating.

    Glad you are asking questions and listening to StutterTalk, Alison!

    Best of luck to you! Tricia 🙂

    • Tricia,
      Thank you for taking time to respond. I’m currently a student, but have a school externship next semester- so I’m certain these suggestions will come in handy. I love the idea of being prepared ahead of time. It might be a good idea to create a stuttering therapy folder using the resources I have so far. I’m always thinking of ways to best serve folks who stutter, especially now before I get myself into these settings and feel lost! I thankfully have a wonderful mentor, who I reach out to with any questions (lucky him). We actually just formed a stuttering support group for kids and teens, so that should be excellent experience for myself and the grad students involved!

      I just have to say, I’m glad there are forums like this for us newbies 🙂 Again, thank you!

      Alison

  2. Hello Allison, and thanks for your great question! You are so right about some feeling uncomfortable treating stuttering because they have not had much experience doing so. The fact that effective stuttering treatment means more than just working on the speech behaviors also makes stuttering more difficult to treat in general. School settings can be difficult because SLPs have a lot of children on their caseloads and may not have the luxury of seeing the child who stutters individually, or even in a small group of children who stutter. So the SLP may be grouping a child who stutters with a child with language difficulties, for example. Another problem in the school setting is that it is difficult to work with parents in that setting. It is so important to get parents on board with what you are doing to help the child with his speech, as well as help parents with their feelings about stuttering. Parents can be a great support to children who stutter, in terms of building a child’s confidence. One way to bring the parents on board would be to enlist the child in helping the parents understand stuttering, or therapy. Scott Yaruss has written about having his school-age clients re-create the therapy session with their parents as homework, which is another way to engage the parents.

    Hope this was helpful to you.
    Kind regards,
    Jean

  3. In my state I have heard of some barriers that are tough. For example, was just told yesterday that the state code doesn’t allow for SLPs to see kids who stutter when there is “no educational impact.” Meaning if a child is severely stuttering, but still participates in class and is doing well academically, they are prevented from putting them on their caseloads. I believe it is all interpretation (and perhaps misinterpretation) of the law, but I find it to be a common report among school SLPs, although not among all.